[Disseminated cryptococcosis mimicking lymphoreticular malignancy: report of one case].
Disseminated cryptococcosis is a rare and often fatal disease in children. The majority of cases usually occur in individuals with defective cell-mediated immunity. We herein reported a 10-year-old boy who presented with fever, body weight loss, lymphadenopathy and marked hepatosplenomegaly. He was admitted under the impression of Hodgkin's disease. However lymph node biopsy revealed diffuse infiltration with polynuclear giant cell and macrophage. Numerous ovoid-shaped microorganisms were found in the cytoplasma of those cells. Cultures of blood, CSF, lymph node, bone marrow and urine all yielded cryptococcus neoformans. The cryptococcal antigen titer of blood was 1:1024 X and that of CSF was 1:64 X. The immune function in terms of T-cell number, mitogen responses, serum immunoglobulin and complement was normal. After the diagnosis of disseminated cryptococcosis was established, the patient was treated with amphotericin B (0.6 mg/kg/day) and 5-fluorocytosine (150 mg/kg/day) for 6 weeks. The patient responded to the treatment very well. Lymphadenopathy and hepatospelomegaly disappeared and no more recurrence was found during the follow-up period of more than 18 months.
Wu
J M
JM
Department of Pediatrics, National Taiwan University Hospital, Taipei, R.O.C.
Lee
C Y
CY
Huang
L M
LM
Lin
K H
KH
Hsieh
K H
KH
Wu
M Z
MZ
D002648:Child; D003453:Cryptococcosis / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006689:Hodgkin Disease / Q000175:diagnosis*; D006801:Humans; D008297:Male